Abstract | OBJECTIVE: MATERIAL AND METHOD: The present prospective observational study comprised 113 patients (184 eyes) with newly diagnosed CMVR, from May 2008-March 2010. Each patient was followed-up every 3 months with medical history and ophthalmologic examination. Patients were divided as visual impairment and legal blindness. RESULTS: The majority of the patients were native Thai (91%), while the rest was of hill tribe origin. 55% were females with age ranged between 14-57 years (average of 39). The main cause of HIV infection was heterosexual contact (90%), followed by homosexual contact (7%). It was found that 68% had CD4 T-cell count less than 50 cells/microl and that 46% had bilateral CMVR. Major causes of visual impairment were CMVR zone 2&3, CMVR zone 1 and cataract, respectively. Major causes of legal blindness were CMVR zone 2&3, CMVR zone 1 and retinal detachment, respectively Retinal detachment was a major risk factor in both groups. Even when surgery was successful, the visual acuity was not significantly improved, indicating a permanent loss of vision. CONCLUSION: In the HAART era, immune recovery of HIV patients also helps restoring specific anti-CMVimmunity. HAART reduces occurrence of visual impairment to 0.10/eye-year (EY) and legal blindness to 0.15/EY, compared to the pre- HAART figures of 0.94-0.98/EY and 0.47-0.49/EY respectively. However, it did not completely eliminate the occurrence. CMVR and cataract remain the most common causes of visual acuity loss followed by retinitis-related retinal detachment, and optic nerve atrophy respectively.
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Authors | Chulaluck Tangmonkongvoragul, Somsanguan Ausayakhun |
Journal | Journal of the Medical Association of Thailand = Chotmaihet thangphaet
(J Med Assoc Thai)
Vol. 95 Suppl 4
Pg. S129-35
(Apr 2012)
ISSN: 0125-2208 [Print] Thailand |
PMID | 22696865
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adolescent
- Adult
- Antiretroviral Therapy, Highly Active
- Cohort Studies
- Cytomegalovirus Retinitis
(complications, diagnosis, therapy)
- Female
- HIV Infections
(complications, drug therapy)
- Hospitals, University
- Humans
- Male
- Middle Aged
- Thailand
- Vision Disorders
(diagnosis, etiology, therapy)
- Young Adult
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